Key takeaways
- Hearing loss can stem from both genetic and non-genetic factors. Genetics contributes to a significant portion of congenital hearing loss in babies.
- As people age, they may experience a gradual decline in hearing, known as presbycusis. Exposure to loud noises can also cause permanent damage to the ears over time.
- Certain medications and various medical conditions can also damage the inner ear or auditory nerve, leading to potential hearing loss. Additionally, certain lifestyle and health factors can increase the risk.
Some causes of hearing loss are unavoidable, like genetics, while others are linked to lifestyle and health conditions you can influence.
In this article, we’ll explain major causes of hearing loss, how to prevent further hearing loss, and how to talk with a doctor.
Genetic hearing loss is
Congenital hearing loss means the hearing loss is present at birth, whether due to genetic or non‑genetic factors.
Genetic differences account for a
Some gene changes affect hearing alone (nonsyndromic), while others occur as part of a broader syndrome affecting multiple body systems (syndromic).
Non‑genetic congenital causes include certain prenatal infections (like
Age‑related hearing loss, medically known as presbycusis, is the gradual loss of hearing that happens as part of the aging process. It typically affects both ears and starts with difficulty hearing high‑frequency sounds.
As we age, the delicate hair cells in the inner ear gradually deteriorate, and changes can occur in the nerve pathways that carry sound signals to the brain. Over time, this leads to reduced hearing ability.
Age‑related hearing loss becomes more common with age. Around
Exposure to loud sounds is a well‑established cause of hearing loss. Loud noises — whether from a single intense event, such as an explosion, or repeated exposure over time — can damage the tiny hair cells in the inner ear that are essential for hearing.
Examples of noise‑related risks:
- working in environments with loud machinery, like construction or manufacturing
- attending frequent loud concerts
- using earbuds or headphones at a high volume
- using firearms or hearing explosions
Once inner‑ear hair cells are damaged, they don’t regenerate, making this type of hearing loss permanent.
Ototoxic medications are drugs that can damage the inner ear or auditory nerve and lead to hearing loss. These effects can be temporary or permanent depending on the drug, dose, and duration of exposure.
Common ototoxic drugs include:
- certain antibiotics, namely macrolides, vancomycin, and aminoglycosides
- loop diuretics, which are for high blood pressure and fluid retention
- certain chemotherapy medications, such as cisplatin and carboplatin
- salicylates (such as aspirin) at high doses
- quinine, a malaria medication
These medications can harm hair cells or nerve cells in the inner ear, potentially causing ringing (tinnitus), balance problems, and hearing loss.
Various medical conditions can affect hearing. Infections that can cause hearing loss include:
- meningitis and other serious infections, which can damage auditory structures
- measles, mumps, rubella, and cytomegalovirus, all of which are linked with hearing complications
- otitis media (middle ear infection), which can lead to temporary or permanent hearing issues if chronic
Non‑infectious conditions that can cause hearing loss include:
- autoimmune inner ear disease, in which the immune system damages ear structures
- Ménière’s disease, an inner‑ear fluid imbalance causing fluctuating hearing and vertigo
- otosclerosis, an atypical bone growth in the middle ear that blocks sound
- diabetes and cardiovascular disease, chronic vascular issues that can impair blood flow in the cochlea and contribute to hearing decline
Many of these conditions affect either the way sound is conducted to the inner ear or how the inner ear processes sound signals.
In addition to the direct causes above, several lifestyle and health factors are associated with a
- smoking, which is linked to worse hearing outcomes, independent of noise exposure
- chronic diseases like diabetes, hypertension, and high cholesterol
- repeated or prolonged loud noise exposure from habits and occupations
- lack of ear protection in noisy settings
These factors don’t always cause hearing loss, but they increase the likelihood or severity of loss over time.
You should schedule an evaluation with a healthcare professional or audiologist if you experience:
- gradual and progressive hearing loss
- difficulty following conversations, especially in noise
- ringing (tinnitus) or balance problems
- persistent earmuffling or blocked sensation
Early assessment helps determine the cause and whether interventions such as hearing aids, medical treatment, or lifestyle changes are appropriate.
If a person experiences rapid hearing loss or hearing loss along with symptoms like pain or discharge, they should seek immediate medical attention.
While not all causes of hearing loss are avoidable, you can protect your hearing with these
- avoid prolonged loud noise and use hearing protection (earplugs, earmuffs)
- keep volume moderate on earbuds and personal listening devices
- manage chronic health conditions such as diabetes and hypertension
- quit smoking if you smoke
- get relevant vaccinations to prevent infections
- discuss ototoxic risks with your doctor before taking high‑risk medications and consider baseline hearing tests
It’s a good idea to consider regular hearing check‑ups, especially if you’re older or at higher risk of hearing loss.
Hearing loss can arise from various sources, including genetic and congenital factors, aging, exposure to loud noise, certain medications, and certain medical conditions, all of which are common contributors.
Lifestyle habits and overall health also play a role in your risk. Understanding these causes and working with your healthcare team can help you protect your hearing and address changes early.